Helena Sunvisson

Changes in motor performance in persons with Parkinson's disease after exercise in a mountain area.

&NA; For one week in autumn, over a period of three consecutive years, a total of 12 persons with Parkinsons disease (PD) participated in daily walks of about 4 kilometers in a mountain area in Sweden in order to train rhythm, balance and coordination on the soft heaths. These persons were 60–78 years of age and had been found to be between stage 1 and stage 3 on the Hoehn and Yahr Staging Scale. The aim of the study was to find out whether a week of daily walks in the Swedish mountains would affect the motor performance of persons with PD, objectively and quantitatively assessed by a computer‐assisted, opto‐electronic movement analysis program, the Posturo‐Locomotor‐Manual (PLM) test. As compared with those before the journey, the results showed improved motor performance both immediately after the walking week and also at 3 but not 6 months later. The first year of participation showed the most pro nounced improvements. The results demonstrate a long‐lasting improvement in decreased movement time, indicating enhanced general motor performance and also an improved simultaneous index (SI), indicating a possible effect on the central nervous system. These findings, along with participants narratives about what they did after returning home, may be indicative of strengthened self‐confidence.

Being the next of kin of an adult person with muscular dystrophy

A chronic disorder affects all members of the family in various ways. The aim of this study is to elucidate the next of kins (N= 36) experiences when an adult family member has muscular dystrophy. The relationships were partner (36%, n= 14), parent (18%, n= 7), child (21%, n= 8), sibling (15%, n= 6), and other relative (3%, n= 1). Latent content analysis is employed and involves an interpretation of the interviewtext. The results showthe meaning of being close to a person with muscular dystrophy through the themes that emerged: exposure of the family; the span between obligation and love; being vigilant, protective, and supportive; and striving for an ordinary life. This study reveals a need for healthcare staff to understand the next of kins narrated meaning of changes when a family member has a progressive disease.

Influencing Self-rated Health Among Adolescent Girls With Dance Intervention: A Randomized Controlled Trial

OBJECTIVE To investigate whether dance intervention influenced self-rated health for adolescent girls with internalizing problems. DESIGN Randomized controlled intervention trial with follow-up measures at 8, 12, and 20 months after baseline. SETTING A Swedish city with a population of 130 000. PARTICIPANTS Girls aged 13 to 18 years with internalizing problems, ie, stress and psychosomatic symptoms. A total of 59 girls were randomized to the intervention group and 53 were randomized to the control group. INTERVENTION The intervention comprised dance classes twice weekly during 8 months. Each dance class lasted 75 minutes and the focus was on the joy of movement, not on performance. MAIN OUTCOME MEASURES Self-rated health was the primary outcome; secondary outcomes were adherence to and experience of the intervention. RESULTS The dance intervention group improved their self-rated health more than the control group at all follow-ups. At baseline, the mean score on a 5-point scale was 3.32 for the dance intervention group and 3.75 for the control group. The difference in mean change was 0.30 (95% CI, -0.01 to 0.61) at 8 months, 0.62 (95% CI, 0.25 to 0.99) at 12 months, and 0.40 (95% CI, 0.04 to 0.77) at 20 months. Among the girls in the intervention group, 67% had an attendance rate of 50% to 100%. A total of 91% of the girls rated the dance intervention as a positive experience. CONCLUSIONS An 8-month dance intervention can improve self-rated health for adolescent girls with internalizing problems. The improvement remained a year after the intervention.

Stopped within a track: embodied experiences of late-stage Parkinson's disease

Based on a phenomenological understanding of humans as situated and intentional beings, this study explored experience of late-stage Parkinsons disease. A woman aged 72, in the late stages of Parkinsons disease, was interviewed regarding her experiences over a five-year period. A phenomenological method was used for scrutinizing tape-recorded and verbatim transcribed interviews. Results reveal that late-stage Parkinsons disease is manifested as a sense of lost control over daily life and as a life with unpredictable bodily reactions. There was a demand to live within an increasingly rigid, slow rhythm of time, with continuously decreased embodied skilfulness, which caused fragmented mobility patterns. Movements were no longer intentional, i.e. outward; they demanded inward concentration. The intention to move was no longer primary, e.g. to grab a handle, because space is mentally and physically understood. Instead, intention was secondary because movement became primary. This phenomenon changed embodied understanding of relationships with the room, distances, and things. Understanding of distance, e.g. became unclear, and this affected ways in which place and situation were experienced and lived. The results highlight ways that a Parkinsons sufferer lives and experiences space and time in surroundings and situations; and how the person meets and deals with significant challenges.

Experiences of dementia in a foreign country: qualitative content analysis of interviews with people with dementia

BackgroundDementia is a worldwide health concern of epidemic proportions. Research in the field of subjective experience of dementia suffers from a lack of diversity of their participants including immigrants. Different portraits of life with dementia could help us understand how people with dementia conceptualise their experiences of dementia and how they live. Our study aimed to explore the subjective experiences of living with dementia among Iranian immigrants in Sweden.MethodsQualitative content analysis of interviews with fifteen people with dementia from Iranian immigrant backgrounds were conducted (8 females and 7 males).ResultsThree themes and seven associated sub-themes were revealed. The themes included: Being a person with dementia means living with forgetfulness (personal sphere), living with forgetfulness in the private sphere means feeling incompetent but still loved, living with forgetfulness in the public sphere means feeling confident and secure but also isolated.ConclusionsLiving with dementia for the participants meant living with forgetfulness. They experienced feeling incompetent but still loved within their families and feeling confident and secure but also isolated in the society. Educating people with dementia and their families about the course and process of dementia may help them understand the changes better and adjust their expectations. Our study can provide a basis for healthcare workers to understand the experiences of living with dementia from this specific perspective.

‘‘I feel free’’: Experiences of a dance intervention for adolescent girls with internalizing problems

Adolescent girls today suffer from internalizing problems such as somatic symptoms and mental health problems at higher rates compared to those of previous decades, and effective interventions are warranted. The aim of this study was to explore the experiences of participating in an 8-month dance intervention. This qualitative study was embedded in a randomized controlled trial of a dance intervention for adolescent girls with internalizing problems. A total of 112 girls aged 13–18 were included in the study. The dance intervention group comprised 59 girls, 24 of whom were strategically chosen to be interviewed. Data were analyzed using qualitative content analysis with an inductive approach. The experiences of the dance intervention resulted in five generic categories: (1) An Oasis from Stress, which represents the fundamental basis of the intervention; (2) Supportive Togetherness, the setting; (3) Enjoyment and Empowerment, the immediate effect; (4) Finding Acceptance and Trust in Own Ability, the outcome; and (5) Dance as Emotional Expression, the use of the intervention. One main category emerged, Finding Embodied Self-Trust That Opens New Doors, which emphasizes the increased trust in the self and the ability to approach life with a sense of freedom and openness. The central understanding of the adolescent girls’ experiences was that the dance intervention enriched and gave access to personal resources. With the non-judgmental atmosphere and supportive togetherness as a safe platform, the enjoyment and empowerment in dancing gave rise to acceptance, trust in ability, and emotional expression. Taken together, this increased self-trust and they discovered a new ability to “claim space.” Findings from this study may provide practical information on designing future interventions for adolescent girls with internalizing problems.

Lived experiences of women with recurring ovarian cancer

BACKGROUND Women with recurring ovarian cancer are living longer, due to advances in treatment options. They are now often outpatients, experiencing rapid encounters on treatment days. Whether this shift in care meets womens needs has been scarcely explored scientifically. PURPOSE OF THE STUDY This study aimed to illuminate the phenomenon of living with recurring ovarian cancer as experienced by women in that condition. METHODS AND SAMPLE A descriptive phenomenological method was used. Eight open-ended interviews with four women were performed approximately three and five years after the first recurrence of ovarian cancer. During these years the women had repeated clinically and radiologically verified recurrence requiring chemotherapy. KEY RESULTS The phenomenon of living with recurring ovarian cancer meant that the women felt forced to pay attention to the failing body in order to avoid a potential breakdown. The growing limitation of their intermittent strength meant that strength had to be captured and protected. Sharing their lives with others was difficult, due to the different living conditions. The women found no space to mediate their experiences, either in close relationships or with health care professionals. But, the circumstances they lived under also generated a gratitude for the unexpected extra time. CONCLUSIONS The findings revealed that the four women were grateful to live a while longer, but needed to share their state of being. The findings are indeed directed to health care professionals, who need to provide a more patient-centred care to meet the womens needs.